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中国癌症防治杂志

中国癌症防治杂志 ›› 2025, Vol. 17 ›› Issue (1): 55-60.doi: 10.3969/j.issn.1674-5671.2025.01.07

• 癌情监测 • 上一篇    下一篇

1990—2021年中国和美国肝癌疾病负担变化趋势及预测

  

  1. 甘肃中医药大学公共卫生学院；2.西北环境与营养相关疾病中医药防治协同创新中心
  • 出版日期:2025-02-25 发布日期:2025-03-06
  • 通讯作者: 魏兴民 E-mail：weixm2004@126.com
  • 基金资助:
    徐州市推动科技创新专项重点研发项目（KC19172）

Changing trends in the disease burden of liver cancer in China and the United States from 1990 to 2021 and its predictions

  • Online:2025-02-25 Published:2025-03-06

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摘要： 目的 比较1990—2021年中国与美国肝癌疾病负担及危险因素的变化和差异，并预测其发展趋势，为我国肝癌的防控提供参考依据。方法 基于全球疾病负担研究2021（Global Burden of Disease Study 2021，GBD 2021），采用Joinpoint回归模型计算1990—2021年两国肝癌年龄标化发病率（age⁃standardized incidence rate，ASIR）、年龄标化患病率（age⁃standardized prevalence rate，ASPR）、年龄标化死亡率（age⁃standardized death rate，ASDR）和年龄标化伤残调整寿命年率（age⁃standardized disability adjusted life years rate，ASDALYR）的平均年度变化百分比（average annual percentage change，AAPC）。采用贝叶斯年龄⁃时期⁃队列分析模型对2022—2035年肝癌疾病负担进行预测。结果 1990—2021年，中国肝癌疾病负担高于美国。2021年，中国肝癌ASIR、ASDR、ASPR和ASDALYR分别为9.52/10万、8.35/10万、13.29/10万和239.91/10万，美国分别为5.58/10万、4.24/10万、9.31/10万和106.24/10万。两国男性肝癌疾病负担均大于女性，且发病率、死亡率和伤残调整寿命年率均随年龄增长而上升。1990—2021年，中国肝癌ASIR（AAPC=-0.31）、ASDR（AAPC=-0.79）和ASDALYR（AAPC=-1.03）呈下降趋势，而美国肝癌ASIR（AAPC=2.81）、ASDR（AAPC=2.43）和ASDALYR（AAPC=2.29）则呈上升趋势。乙型肝炎病毒（hepatitis B virus，HBV）感染和丙型肝炎病毒（hepatitis C virus，HCV）感染是我国肝癌死亡的主要危险因素，而美国则为HCV感染、饮酒和吸毒。预计2022—2035年中国肝癌疾病负担整体呈下降趋势，而美国则呈上升趋势。结论 中国肝癌疾病负担虽呈下降趋势，但仍高于美国，应继续加强对男性和中老年人群的肝癌防控工作。

关键词: 肝癌, 疾病负担, Joinpoint回归模型, 危险因素, 预测分析

Abstract: Objective To compare the changes and differences in the disease burden and risk factors of liver cancer between China and the United States from 1990 to 2021, predict future trends, and provide evidence⁃based recommendations for liver cancer prevention and control strategies. Methods This study was based on the Global Burden of Disease Study 2021 (GBD 2021) database. Joinpoint regression analysis was employed to calculate the age⁃standardized incidence rate (ASIR), age⁃standardized prevalence rate (ASPR), age⁃standardized death rate (ASDR) and age⁃standardized disability adjusted life years rate (ASDALYR), as well as the average annual percentage change (AAPC) of each indicator of liver cancer in China and the United States from 1990 to 2021. The Bayesian age⁃period⁃cohort  model was used to predict the disease burden of liver cancer from 2022 to 2035. Results From 1990 to 2021, the disease burden of liver cancer in China was higher than that in the United States. In 2021, the ASIR, ASDR, ASPR, and ASDALY of liver cancer in China were 9.52/105, 8.35/105, 13.29/105, and 239.91/105, respectively. In contrast, the corresponding rates in the United States were 5.58/105, 4.24/105, 9.31/105, and 106.24/105, respectively. The disease burden of liver cancer was higher among males than females in both countries, and the incidence, mortality, and disability⁃adjusted life years rate increased with age. From 1990 to 2021, the ASIR (AAPC=-0.31), ASDR (AAPC=-0.79), and ASDALY rate (AAPC=-1.03) for liver cancer in China showed a declining trend. In contrast, in the United States the ASIR (AAPC=2.81), ASDR (AAPC=2.43) and ASDALY rates (AAPC=2.29) all demonstrated an increasing trend. Hepatitis B virus (HBV) infection and hepatitis C virus (HCV) infection were the leading risk factors for liver cancer⁃related deaths in China, whereas HCV infection, drug use and alcohol use were the predominant risk factors in the United States. It is projected that the disease burden of liver cancer in China will show an overall declining trend from 2022 to 2035, while in the United States, it is expected to slightly increase during the same period. Conclusions Although the disease burden of liver cancer in China is declining, it remains higher than that in the United States. Continued efforts to strengthen prevention and control measures for liver cancer are essential, particularly among men and middle⁃aged to elderly populations.

Key words: Liver cancer, Disease burden, Joinpoint regression model, Risk factors, Predictive analysis

中图分类号: 

  • R735.7